COLON POLYPS

A small clump of cells that forms on the lining of the colon is known as colon polyp. Most colon polyps are harmless. Nevertheless, over time, some colon polyps can develop into colon cancer, which is often fatal when it is discovered in the later stages.

Who is at risk for Colon Polyps?

Anyone can develop colon polyps. You’re at a higher risk if you’re:

  • Fifty or older
  • Overweight
  • A smoker
  • Have a personal or family history of the condition

It’s important to have regular screening tests, such as a colonoscopy as the condition often cause no external symptoms. Colon polyps found in the early stages can usually be removed safely and completely.

How many types of colon polyps are there?

  • Adenomatous: Only a small percentage of them actually become cancerous. But nearly all-malignant polyps are adenomatous. About two-thirds of all polyps are adenomatous.
  • Serrated: Based on the size and location in the colon, serrated polyps may turn cancerous. Normally small-serrated polyps in the lower colon are also known as hyperplastic polyps. They are rarely malignant. Whereas larger serrated polyps, which are typically flat (sessile), difficult to detect and located in the upper colon are pre-cancerous.
  • Inflammatory:These polyps may follow a bout of ulcerative colitis or Crohn’s disease (colon). Even though the polyps are not a significant threat, having ulcerative colitis or Crohn’s disease (colon) increases your overall risk of developing colon cancer.

What do colon polyps look like?

COLON POLYPS

 

Most polyps are protrusions from the lining of the intestine:

 

 

  • Polypoid polyps:They look like a mushroom and flop around the inside the intestine as they are attached to the lining of the colon by a thin stalk.
  • Sessile polyps:These polyps do not have a stalk and they are attached to the lining by a broad base.
  • Flat polyps:They are the least common type of colon polyp. They are either totally flat or slightly depressed. Flat polyps may be difficult to identify, as they are not as prominent as other types of polyps described above.

EARLY SYMPTOMS FOR COLON POLYPS

Most of the time, this condition does not cause any symptoms. You might not know you have a polyp until your doctor discovers it during an examination of your bowel. However, some people with colon polyps experience:

  • Rectal bleeding:This may be a sign of colon polyps, cancer or other conditions such as haemorrhoid or minor tears in the anus.
  • Change in stool colour:Red streaks of blood may show up in your stool or make your stool appear black. Colour changes may also be caused by foods, medications and supplements.
  • Change in bowel habits: Constipation or diarrhoea that continues for more than a week may indicate the presence of a large colon polyp. However, a number of other conditions can also cause changes in bowel habits.
  • Pain, nausea or vomiting:Large colon polyps can partially block your bowel that can lead to abdominal pain, nausea and vomiting.
  • Iron deficiency anaemia:Polyp bleeding can occur slowly over time, without visible blood in your stool. Chronic bleeding will lead to iron deficiency anaemia, which can make you feel tired and short of breath.

TREATMENT OPTIONS FOR COLON POLYPS

Your doctor will most likely remove all polyps discovered during a bowel examination. The options for removal are:

  • Removal during screening:Most polyps can be removed with biopsy forceps or a wire loop that grabs the polyp. If a polyp is larger than 0.75 inches, a liquid may be injected under it to lift and isolate the polyps from surrounding tissue so that it can be removed easily (endoscopic mucosal resection).
  • Minimally invasive surgery: This technique is used to remove the polyps when they are too large or when they can’t be reached safely during screening.
  • Colon and rectum removal: Surgery may be needed to remove your colon and rectum (total proctocolectomy) if you have a rare inherited syndrome such as FAP.

Some types of colon polyp are more likely to become malignant compared to others. A pathologist normally examines polyp tissue under a microscope to determine if it is cancerous or not.

DIAGNOSTIC SERVICES AVAILABLE FOR COLON POLYPS

Screening tests are crucial in detecting polyps before they turn cancerous. These tests can also help find colorectal cancer in its early stages when it is still treatable.

Screening methods are:

  • Colonoscopy: This test allows your doctor to look at the inner lining of your large intestines where they will use a thin, flexible tube called a colonoscope to look at the colon. This is the most sensitive test for colorectal polyps and cancer. If polyps are discovered, they may be removed immediately or biopsy samples will be taken to determine the nature of the polyps.

COLONOSCOPY

  • Virtual colonoscopy (CT colonography):This is a minimally invasive test that uses a CT scan to view your colon. The preparation for virtual colonoscopy is the same as a colonoscopy. If a polyp is present, you’ll need colonoscopy to have it removed.
  • Flexible sigmoidoscopy:A slender, lighted tube is inserted in your rectum and the last third of your colon for examination. If a polyp is found, you’ll need colonoscopy to have it removed.

Do all colon cancers arise from polyps?No, even though most of them are associated with polyps, some are not. Some arise within the wall of the colon. They may appear flat or even depressed. These types are more difficult to identify and treat. They are more likely to spread into the wall of the colon and nearby lymph nodes compared to cancers originating from polyps. This is normally the case for serrated adenomatous polyps that normally appear flat rather than polypoid.

What type of follow up care is required after polyp removal?

If you’ve had an adenomatous polyp or a serrated polyp, the risk of developing colon cancer is increased. The level of risk depends on the size, number and characteristics of the adenomatous polyps that were previously removed.Follow-up screenings for polyps will be recommended. Your doctor will likely recommend colonoscopy:

  • In five years (if you only had one or two small adenomas)
  • In three years (if you had more than two adenomas that were larger than 0.4 inches and adenomas with a broad base)
  • Within three years (if you had more than 10 adenomas)
  • Within six months (if you had a large adenoma or an adenoma that had to be removed in pieces)

It’s crucial to fully prepare your colon before colonoscopy. If stool is present in the colon at the time of the colonoscopy and obstructs your doctor’s view, you will likely need another colonoscopy sooner than the guidelines specify.